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The FHK demonstration received a lot of attention and special effort -- from FHCP, FHKC, the Volusia County School District, and others.
When the demonstration was being planned and initially implemented, all of the important agencies concerned with the demonstration -- specifically, FHKC, FHCP, the State Medicaid program, and a health actuary -- concurred that this was a risky target population.
In other words, 2 years into the demonstration, costs had declined over 20 percent from original estimates, as against the 24-percent increase that demonstration planners had originally assumed (information provided by FHKC).
While this issue raises notably complex and contested issues, there are three reasons that FHKC officials and others were pleased with the results:
* Beneficiary satisfaction rates were high, and FHKC's own surveys of disenrollees showed small percentages of disenrollment because of dissatisfaction with the FHK coverage.
The initial idea for the FHKC was not that it would become an operating agency, but rather that it would be an incubator of school-enrollment-based health coverage for uninsured children.
As the 3-year demonstration was drawing to a close in 1995, FHKC was actively working to replicate the demonstration model in other counties.
The State legislature has considered proposals to extend the FHK model statewide, but FHKC and others have resisted this mandated extension of the program.
Thereafter, according to accounts of State, FHKC, school, and provider staff, the school-based enrollment process became an administratively simple way to determine eligibility for Healthy Kids.
Another problem mentioned by FHKC staff is low enrollment among older (middle school and high school) children, possibly due to the stigma of applying for the school lunch program.
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